Urban reality: a fast track to obesity

Where you live has a profound effect on your chances of
staying healthy.

AS MELBOURNE expands, so will the number of people suffering
heart attacks, obesity and related diseases - unless urban planners
start designing developments that guarantee ready access to
healthy, affordable food.

While state and federal governments bombard the community with
expensive "healthy eating" campaigns, experts are concerned many
families who don't have cars have difficulty getting to their local
supermarket to buy fruit and vegetables because public transport is
poor.

"Healthy food is one of the most important parts of our health,"
says VicHealth chief executive Rob Moodie. "Urban planners should
look at how to plan health into our environment rather than plan it
out.

"It's evident that there is a significant proportion of the
population in Victoria that doesn't get access to food and a much
bigger proportion that doesn't get access to good food."

There are in effect two Melbournes. One has ready access to
good-quality cheap food, high car ownership and is well serviced by
public transport; the other is often kilometres from a supermarket
and plagued by transport problems. Members of the first earn a
decent income; the second are often the working poor and those on
government pensions.

Food security, as it is called, has major implications for the
long-term health of a significant proportion of Victorians.
Numerous studies link poor diet with obesity, cardiovascular
diseases, bowel cancer, asthma and a host of other illnesses.

"Where you live matters," says University of Melbourne research
fellow Lyndal Thomas. "For example, over and above the effects of
an individual's socioeconomic status, if you live in a
disadvantaged area you are on average 65 per cent more likely to
eat fast food weekly at home."

Thomas says that, on average, there is one fast-food shop in the
highest-income areas, compared with three or four in low and
middle-income areas.

Put simply, the likelihood of a family eating fast food at home
is directly related to its availability in the area, and jumps 9
per cent with every new takeaway shop.

The reason is clear-cut, says Cath Burns, an obesity researcher
with Deakin University. Poor public transport in many disadvantaged
areas makes it difficult to get to a supermarket.

"Transport is a major issue particularly in growth belts because
the infrastructure hasn't caught up yet. Even in established areas,
transport for the elderly, single mothers and the disabled is
crucial," she says.

The rising cost of healthy food is also an issue, researchers
say. According to the Department of Human Services, up to 50,000
Victorians go without food at least once a month and once a year
the dinner plate is empty for about 1 in 20 adult Victorians,
simply because they cannot afford it.

Health professionals and researchers say these figures indicate
a much wider problem, with many more parents forced to feed their
families with cheap, unhealthy foods.

Using data from the Australian Bureau of Statistics, the
Australian Greens calculate that while food as a category has risen
almost 30 per cent in price since 2000, snack foods have increased
19 per cent, while fruit and vegetables soared 63 per cent (and
that's only slightly banana-related).

Health economists say this is because processed foods that
contain high levels of fat, sugar and salt are cheaper to produce
than nutritious foods.

"Fattening food is cheap," says Burns. "Calorie for calorie,
foods that are high in energy and low in nutrients are much
cheaper.

"The bottom line is, if you have a minimum amount of money and
kids to feed, you are going to buy a packet of biscuits for $1.50,
you aren't going to buy a kilo of apples for $4."

Professor Garry Jennings of the Baker Heart Research Institute,
who like Moodie supports a fat tax, says poor diet is one of the
major reasons why people from disadvantaged areas have higher death
rates from cardiovascular disease, heart attack and stroke.

"The old notion of the harassed executive getting a heart attack
is the complete opposite of what happens. It is among people who
are struggling with financial and socioeconomic stress where you
see most cardiovascular disease," he says.

Paradoxically, obesity, which is a major contributor to heart
disease, is also a problem in low-income areas. Cheap foods are
temporarily filling but often high in fat and sugar. US and
European research has found that obesity is 40 per cent higher
among women from lower socioeconomic backgrounds.

DIVIDED MELBOURNE KEY FACTS

· Those in poorer neighbourhoods are 65 per cent more
likely to eat fast food at home than high-income areas.

· Lack of public transport is acute in low-income areas and
new growth corridors. This makes it harder to get to supermarkets
for fresh food.

· One in 20 Victorians cannot afford to eat at least once a
year.

· Low-income women are 40 per cent more likely to be
obese.

· People from disadvantaged areas are between 1.6 and 1.9
times more likely to die from cardiovascular disease, coronary
heart disease and stroke.

SOURCE: Deakin University, University of Melbourne and
Australian Institute of Health and Welfare